Middle range theory is a dimension of nursing knowledge with promise for guiding practice and research. Imogene King in the early 1960s developed the Goal Attainment theory which describes a dynamic, interpersonal relationship in which a patient grows and develops to attain certain life goals. (king,1992). It is a process of human interactions between nurse and client whereby each perceives the other and the situation, and through communication, they set goals, explore means, and agree on means to achieve goals.
Katharine Kolcaba’s middle range nursing theory on the other hand is centered on comfort. It was first developed in 1991 based on holism and human needs, this theory is described by two ideas such as type of comfort (relief, ease, transcendence) and context for comfort (physical, psychospiritual, environmental, social). Kolcaba described Patient comfort as strengthening the immediate state of being through physical, psychospiritual, social, and environmental nursing interventions in the context of institutional outcomes (Liehr & Smith 2017). Patients experience a sense of relief when their individual comfort needs are met. Patients are at ease in situations that enable them to be calm or content.
To compare and contrast both theories, Katharine Kolcaba’s middle range theory of comfort can be used to enhance the environment of patients in cardiac care where the patients are subjected to noise, interruptions, as well as a myriad of monitoring alarms. A loud and chaotic environment can negatively affect healing process of patients. Through the use of a “quiet time” intervention derived from comfort theory when applied in care of cardiac patients it will greatly improve cardiac patients’ experiences of comfort. (Krinsky, et al 2014). The theory of goal attainment describes the goal of nurse patient interactions that lead to transactions and goal attainment. Goal setting is based on the nurse’s assessment of the patients concerns, problems and disturbances in health, their perception of problems and their sharing of information with patients and their families to move toward quality improvement in their health.
These ideal middle range theories coupled with clinical research can help equip hospitals and nurses with effective methods to improve patient comfort, attain established goals through communication in order to facilitate healing. Imogen goal attainment theory provides knowledge, process and outcome, it is the heart of quality assurance programs in healthcare and leads to quality improvement in nursing. As Katharine Kolcaba stated, if patients experience comfort, then they are more satisfied with the care given, and the nurses as well as the institution will benefit. Both theories can be utilized to achieve quality improvement.
References
King I. M. (1992). King’s theory of goal attainment. Nursing science quarterly, 5(1), 19–26. https://doi.org/10.1177/089431849200500107
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